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Frankly Speaking About Lung Cancer. Living Well with Lung Cancer: Take Control of Symptoms & Side Effects . Frankly Speaking About Lung Cancer Managing Symptoms & Side Effects. Effective symptom management Requires early identification or prevention Improves quality of life

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frankly speaking about lung cancer
Frankly Speaking About Lung Cancer

Living Well with Lung Cancer:

Take Control of Symptoms & Side Effects

frankly speaking about lung cancer managing symptoms side effects
Frankly Speaking About Lung CancerManaging Symptoms & Side Effects
  • Effective symptom management
    • Requires early identification or

prevention

    • Improves quality of life
    • Optimizes treatment potential
    • Should be a factor when deciding which

treatment is best

slide3

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

Common Lung Cancer Signs & Symptoms:

  • Pain
  • Confusion
  • Depression
  • Swelling of neck/face
  • Blood clots
  • Cough or Coughing up

blood (Hemoptysis)

  • Trouble breathing
  • Loss of appetite/weight

loss

  • Fatigue/anemia
frankly speaking about lung cancer managing symptoms side effects4
Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

Common Side Effects of Treatment:

  • Fatigue
  • Trouble breathing
  • Pain
  • Nausea & Vomiting
  • Peripheral neuropathy
  • Low blood counts
  • Infection
  • Alopecia (hair loss)
  • Diarrhea/constipation
  • Loss of appetite
  • Mouth sores
  • Skin changes
  • Sexual/reproductive

changes

is it the cancer or something else

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

“Is it the cancer or something else?”
  • No easy answer.

GOAL: Take control of the symptoms of the disease & the side-effects of treatment!

        • Be aware
        • Be Patient Active
frankly speaking about lung cancer managing symptoms side effects6
Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

FATIGUE

Sustained and overwhelming sense of exhaustion & decreased energy for both mental & physical work

This most common & debilitating symptom

may be related to:

  • The lung cancer itself
  • Effects of treatment (low red blood cells,etc)
  • Emotional distress
fatigue

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

FATIGUE

To manage fatigue:

  • Conserve energy- avoid emotional drains
  • Get uninterrupted relaxation: music, reading, meditation, prayer…
  • Do regular physical activity
  • Minimize unnecessary bed rest
  • Talk with your health care team about medications that treat anemia

Inactivity leads to muscle loss…muscle loss leads to fatigue!

trouble breathing

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

TROUBLE BREATHING

Air hunger that causes difficulty breathing

May be caused by:

  • the tumor itself
  • anxiety
  • anemia (low rbcs)
  • infection
  • radiation therapy
  • chemotherapy drugs
  • chest surgery
trouble breathing9

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

TROUBLE BREATHING

To manage breathing

  • First-determine underlying cause!
  • Relaxation exercises/controlled breathing
  • Practice “abdominal breathing”
    • Exhale slowly through pursed lips, squeezing abdominal muscles upward and inward. Inhale through nose, abdomen will rise as diaphragm lowers
  • Oxygen use
  • Bronchodilators/ steroids/ inhalers
  • Adjust posture or body position
slide10

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

  • PAIN
  • Cancer pain may steadily get worse & will not go away without treatment
  • Short or long term: can rob you of your quality of life!
  • May be caused by:
    • post-operative state
    • chemotherapy
    • radiation
    • the cancer itself
slide11

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

PAIN

Take control of pain:

  • Tell somebody about it!
  • Pain can be controlled
  • You have the RIGHT to be pain-free
  • Find a physician/pain specialist who will help

you control pain

  • Patients in pain do not get addicted

to pain medications

slide12

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

PAIN

  • Pain Management Tools:
    • Medications (short & long acting, tablets,

liquid, patch, injection)

    • Behavior modification
    • Pain control devices (TENS unit)
    • Heating pad, ice, internal pump
    • Relaxation, meditation, massage…
slide13

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

NAUSEA & VOMITING

  • Can be effectively controlled. Three types of chemo-induced nausea & vomiting:
  • Acute- Occurs within 24 hrs. of chemo.
  • Delayed- Occurs 24 hrs. after chemo and can last 6-7 days
  • Anticipatory- A learned response to n/v in previous treatments.
  • May be caused by:
  • treatments such as chemotherapy, radiation, surgery
  • anesthesia
  • constipation, etc.
slide14

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

NAUSEA & VOMITING

Take control of N/V with medication:

  • Premedicate for chemo/radiation with an

antiemetic regimen + steroid= improved QOL

  • Antiemetic medications (given orally and/or IV)

such as Zofran,Kytril, Anzemet

  • Zofran: only antiemetic FDA-approved for

prevention of N/V day 1 & 2 after chemo/xrt

slide15

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

NAUSEA & VOMITING

Take control of N/V through diet:

  • Small, frequent, bland meals
  • Avoid fried, fatty, & sweet foods
  • Eat & drink slowly, chew food well
  • Suck on ice cubes, mints, or tart candies
  • Eat foods served at room temperature
  • Relax, breath deeply
  • Drink peppermint or ginger tea
slide16

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

PERIPHERAL NEUROPATHY

Burning, tingling, weakness, pain, or numbness in hands or feet that can make it difficult to walk, hold objects, use your fingers…

  • May be caused by:
  • nerve changes as result of certain types of chemo.
  • tumor pressing on nerves
slide17

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

PERIPHERAL NEUROPATHY

Take control of PN:

  • Notify your MD of the first indication!
  • Be aware of limitations

Muscle weakness, decreased sensitivity to hot/cold & sharp objects

  • Prevent falls
    • use handrails
    • always wear shoes or hard-sole slippers
    • remove throw rugs
  • Avoid extreme hot/cold
slide18

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

THROMBOCYTOPENIA

Known as “Low Platelet Count”: Results in tendency to bleed and bruise easily

  • May be caused by:
  • chemotherapy destroying healthy cells and/or

platelets

slide19

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

THROMBOCYTOPENIA

Take control of low platelet counts:

  • Keep track of CBC results
  • Ask MD or nurse if low platelets may occur with your type of treatment
  • Report unusual bleeding/bruising
  • Use soft bristle toothbrush
  • Avoid contact sports
  • Use electric razor for shaving
  • Avoid enemas, rectal suppositories
slide20

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

INFECTION

The presence and growth of a microorganism that damages tissue. Potentially life threatening complication!

  • May be caused by:
  • chemotherapy destroying white blood cells/

Neutrophils

  • exposure to bacteria
  • complication with surgery or radiation
  • bronchoscopy
slide21

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

INFECTION

Take control of infection:

  • Talk with your doctor about treatment to reduce the duration of low wbc counts
  • Wash hands regularly
  • Avoid people with cold and flu
  • Check blood counts
  • Avoid tobacco smoke

Prevention and close monitoring is critical!

slide22

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

INFECTION

Immediately notify your MD if symptoms arise:

  • Fever, 100.5 or higher
  • Burning with urination
  • Severe chills
  • Redness, pain, swelling or pus at central line site or an incision line
  • Trouble breathing or productive cough
  • Mental confusion
slide23

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

ALOPECIA

Hair loss -usually begins 3-4 weeks after chemo starts. Can be extremely traumatic

  • May be caused by:
  • Chemotherapy --Death of rapidly dividing cells hair

follicles): Will grow back. (Not all chemotherapy

causes hair loss)

  • Radiation to head --Permanent damage to hair

follicles: Usually does not grow back

slide24

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

ALOPECIA

Take control of hair loss:

  • Cut hair or shave head before hair loss starts
  • Buy a wig or hairpiece before hair loss starts
  • Use mild shampoos & soft hairbrushes
  • Avoid hair dyes & permanent waves
  • Use sunscreen on scalp
diarrhea

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

DIARRHEA

Increase in the liquidity & frequency of stool resulting from irritation of the intestines

May be caused by:

  • certain chemotherapy drugs
  • infection
  • drug reactions
  • diet alterations
diarrhea26

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

DIARRHEA

Take control of diarrhea:

  • Call your MD immediately if:
    • diarrhea is severe for 24 hours or more
    • it is combined with fever, blood in stool, or severe pain
  • Call your MD before using OTC drugs
diarrhea27

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

DIARRHEA

Manage diet:

  • Eat small frequent meals
  • Eat potassium-rich foods (banana, apricot)
  • Drink plenty of fluids (enough to replace loss)
  • Avoid the following:
    • High-fiber foods
    • Fried, greasy, or spicy foods
    • Caffeinated products: coffee, tea, soda
    • Milk and milk products
slide28

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

CONSTIPATION

Decrease in frequency and/or passage of hard, dry stools

  • May be caused by:
  • pain medications
  • certain chemotherapy drugs
  • inactivity & fatigue
  • diet alterations
slide29

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

CONSTIPATION

Take control of constipation (especially if on pain medicine):

  • Drink plenty of fluids (warm/hot)
  • Eat high-fiber foods (bran, whole wheat breads, cereals, veggies, popcorn)
  • Increase your physical activity (walk, stretching exercises, yoga, Tai Chi, etc.)
  • Stool softeners & laxatives only with MD ok
slide30

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

WEIGHT LOSS

Unexpected loss of, or diminished appetite. Can lead to anorexia

May be caused by:

  • the lung cancer disease process
  • chemotherapy
  • radiation therapy
  • constipation
  • nausea
  • depression & anxiety
slide31

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

WEIGHT LOSS

Take control of food intake:

  • Eat small, frequent meals/snacks
  • Try new foods or high protein/calorie nutritional

supplements (Boost/ Power Bars/ etc..)

  • Light exercise may make you hungry
  • Arrange nice surroundings for eating
  • Eat whatever sounds & tastes good to you!
  • Eat whatever & whenever you want!

Adequate nutrition is essential to recovery!

slide32

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

MOUTH SORES

Can occur 2-5 days after chemo, and 1-2 weeks after radiation starts. Can last for up to 2 weeks. Can range from mild to severe (open bleeding) sores in mouth & throat

slide33

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

MOUTH SORES

Take control of mouth sores:

  • Have an oral exam, cleaning, etc. before treatment
  • Brush teeth gently with soft bristle brush & toothpaste with mild abrasives
  • Rinse mouth with salt water (1t. Salt to 1qt. water)
  • Avoid salty, acidic, spicy foods
  • Drink through straw
  • Limit/eliminate tobacco & alcohol
  • Notify MD of mouth sores. Take pain meds, antibiotics, anti-fungals as prescribed
slide34

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

RADIATION FIBROSIS

The formation of scar tissue in lung following radiation treatment. May be temporary & could develop months or years following radiation therapy. May affect your breathing & comfort

Symptoms:

  • Dry mouth or sore throat
  • Difficulty breathing or swallowing
slide35

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

SKIN CHANGES

Can include pain, redness, scaling, dryness, sun sensitivity, hives. Radiation skin changes only occur at site to which RT was delivered

May be caused by:

  • can be from chemo drugs
  • radiation treatments
  • sun exposure
slide36

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

SKIN CHANGES

To manage skin changes:

  • If receiving radiotherapy, talk to

MD/nurse about special skin care

  • Use skin lotions containing aloe or

lanolin- apply frequently

  • Take cool or warm baths/showers
  • Gently towel dry the sensitive area
slide37

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

CONCLUSIONS

  • The key to is to take control of symptoms & treatment side effects
    • Maintain open communication with your health care team
    • Take side effects into account when making decisions about which treatment to have– You do have choices!
slide38

Frankly Speaking About Lung CancerManaging Symptoms & Side Effects

CONCLUSIONS cont.

  • Clinical trials are looking at more effective methods to manage side effects & symptoms
  • Newer treatments may offer better efficacy & fewer side effects
  • Treatment can make your symptoms better & improve your QOL!
  • Being involved in treatment decisions up front may allow you to take better control of side effects
slide39

Frankly Speaking About Lung Cancer

Living Well With Lung Cancer:

Take Control of Symptoms & Side Effects

Questions & Answers